SUMMARY

• Given its potential to induce dissociative effects, carefully assess patients with psychosis before administering SPRAVATO; treatment should be initiated only if the benefit outweighs the risk.¹
• Carter et al (2022)² presented a case report of a 28-year-old patient with treatment- resistant depression (TRD) with psychotic features who was treated with SPRAVATO over a period of three months.

Case Report

Carter et al (2022)² presented a case report of a 28-year-old African American female with TRD with psychotic features, which included auditory and visual hallucinations of self-harm and harming others. Her past medical history included generalized anxiety disorder and difficulty sleeping. After prior inadequate response to several antidepressants, antipsychotics, and mood stabilizers in combination with cognitive behavioral therapy (CBT), the patient was initiated on SPRAVATO along with other continued medications (bupropion 150 mg, aripiprazole 10 mg, trazodone 100 mg, clonazepam 0.5 mg, and sertraline 50 mg).

The patient was treated with SPRAVATO for a period of three months (14 treatment sessions) at an initiation dose of 56 mg which continued through induction and thereafter was increased to 84 mg. SPRAVATO was administered twice weekly for the first 8 sessions, weekly for the next 4 sessions, and then every two weeks. The Quick Inventory of Depressive Symptomology (QIDS) was used to evaluate the depressive symptoms at the beginning of each session. Pre-treatment QIDS score was 17 (severe depression), which reduced to 15 after 3 treatment sessions, and further decreased to 5 after 12 sessions. Nine months post treatment, the patient continued to be stable (QIDS, 8), with significantly reduced visualizations of self-harm and no auditory hallucinations. The patient reported less anhedonia, anxiety, and reduction in the number of times she had to miss work.

Literature Search

A literature search of MEDLINE^®, EMBASE^®, BIOSIS Previews^®, and DERWENT Drug databases (and/or other resources, including internal/external databases) pertaining to this topic was conducted on 25 June 2024.